Effect of Dexmedetomidine on Postoperative Sleep Quality: A Systematic Review

Abstract

In this article, we conduct a systematic review of the literature to explore the specific role of dexmedetomidine (DEX) on postoperative sleep and its associated mechanisms at present. The electronic database Embase, MEDLINE/PubMed, the Cochrane Library, Web of Science, and Google Scholar were searched. The restriction terms included "dexmedetomidine", "sleep" and "surgery". The inclusion criteria were as following: 1) patients 18 years old or older; 2) DEX used in the perioperative period not just for critically ill patients in the intensive care unit (ICU); 3) prospective or retrospective studies. The review articles, conference abstracts, and animal studies were excluded. Out of the 22 articles which met the above criteria, 20 of them were randomized controlled studies and 2 of them were retrospective cohort studies. Infusion of DEX including during the surgery and after surgery at a low or high dose was shown to improve subjective and objective sleep quality, although 2 studies showed there is no evidence that the use of DEX improves sleep quality and 1 showed less sleep efficiency and shorter total sleep time in the DEX group. Other postoperative outcomes evaluated postoperative nausea and vomiting, pain, postoperative delirium bradycardia and hypotension. Outcomes of our systematic review showed that DEX has advantages in improving patients' postoperative sleep quality. Combined with the use of general anesthetic, DEX provides a reliable choice for procedural sedation.

Effect of Perioperative Dexmedetomidine Infusion on Postoperative Delirium in Elderly Patients Undergoing Oral and Maxillofacial Surgery: A Randomized Controlled Clinical Trial

“…Dexmedetomidine is widely used as a sedative. In 2021, Huang et al published a systematic review showing that dexmedetomidine had advantages in improving postoperative sleep quality, 34 which was consistent with our results that dexmedetomidine improved the RCSQ scores in elderly patients undergoing oral and maxillofacial surgery. Sleep deprivation was reported to be closely related to delirium, 35 however, in this study, dexmedetomidine improved sleep quality but did not improve delirium symptoms.…”

Analgesic and Sedative Effects of Different Doses of Dexmedetomidine Combined with Butorphanol in Continuous Analgesia after a Cesarean Section

“…Dexmedetomidine acts on the α2 adrenoceptor agonist in the nucleus locus coeruleus, reduces the release of norepinephrine, simulates natural sleep, and produces sedative, hypnotic, and anxiolytic effects ( 28 , 29 ). In the present study, we found that dexmedetomidine combined with butorphanol can improve the sedative effects (according to the Ramsay score) in continuous analgesia after a cesarean section, and the analgesic and sedative effects of dexmedetomidine in the high-dose group are better than those in the low-dose group, which is consistent with the findings of Zhang et al ( 30 ).…”

Recent Advances in the Clinical Value and Potential of Dexmedetomidine

“… 102 A recent systematic review showed that dexmedetomidine has advantages in improving patients’ postoperative sleep quality. 103 Other studies have also assessed the feasibility of patient-controlled sleep with dexmedetomidine in treating chronic intractable insomnia. Patient-controlled analgesia (PCA) is an “on-demand” system that allows patients to self-administer intravenous medications in small bolus doses.…”